Contesting The Concept of Professionalism

Professionalism is both a concept and a term I have long since regarded with an incredulous ambivalence. Semantically, the word is rendered increasingly ambiguous by the ubiquity with which modern America uses it. It leads to the inevitable and frankly valid question of what is a professional. We have professional athletes, distinguished by their skill and compensation. Professional workmen are differentiated by the quality of their product and certifications supporting their expertise. A professional artist differs from a casual artist, hobbyist or amateur in the amount of time they invest to their art and the living they receive from it. So is a professional someone with unusual skill and expertise, someone with certifiable experience, someone compensated for their passion or someone that devotes (or professes) a significant amount of their time and energy to a calling? Depending on the context, it could be any or all of these things. So if “professionalism” is the act of being professional, or the characteristics that differentiate a professional from the rest, which working definition do we choose? The general consensus seems to point towards “professionalism” being a high standard of behavior, expertise, trustworthiness, attitude and dress. This presents a conflict, however. Our professional plumbers adhere to no dress code. Our professional athletes rarely demonstrate a high standard of behavior. Our professional artists often intentionally contradict conventional standards of behavior. Our general consensus on the meaning of professionalism often fails to be demonstrated by our professionals. So really, how accurate is it?

But that is merely the semantic argument against the term “professionalism”. Of greater importance are the questions regarding the concept itself. This working definition of professionalism that encourages standards of ethical behavior, morality, honesty, transparency, compassion, tolerance, punctuality, preparedness and an almost endless list of other favorable qualities should be obvious, should it not? In many ways, the concept is regarded as so obvious as to not be taught at all. Of my numerous acquaintances and peers that are either progressing through or have completed their legal or medical degrees (two of the three occupations formally recognized as professions, with clergy being the third) not one of them has ever had a lecture on “professionalism”. Anecdotal evidence is hardly convincing but it does raise a telling question; why is it that pharmacy curriculums appear to be the ones pushing “professionalism” the hardest of any profession? Why is it that medical and legal schools consider a high standard of moral and ethical behavior to be understood, but pharmacy curriculums feel the need to aggressively teach it? The largest difference between the programs appears to be the age at which people begin them. Most legal and medical schools accept students that have already completed 3-4 years of education, whereas numerous pharmacy schools will accept students, often as young as 17, right out of high school. Perhaps the difference in maturity levels between pharmacy entrants and medical/legal entrants is the reason. Perhaps the nation’s “Most Trusted Professional” is held to an even greater standard than our physicians, lawyers and priests? Either of these reasons may help to explain the discrepancy but I cannot help but feel that neither tells the whole story. Although certainly not the sole reason, is it possible that professionalism is so aggressively lectured in pharmacy schools out of fear of what would happen if it wasn’t? Is it possible that America trusts pharmacists more than pharmacists trust each other?

But at least the deluge of lecturing on professionalism (seven lectures in three years across five courses by my count) has had a positive effect, right? Not in my experience, and this isn’t really surprising. Those students that were unprofessional five years ago remain unprofessional today. Those students that are paragons of professionalism have always been so, long before they came to pharmacy school. In my opinion, the lectures on professionalism have had no appreciable effect. I believe this is due to “professionalism” being intrinsically motivated. One must hold –themselves- to high standards of moral, ethical and generally appropriate behavior. A person that isn’t intrinsically motivated to do so will surely fail to be extrinsically motivated. This is not to say that the lectures were necessarily wasted. It is usually beneficial to review good practices. And due to the inherently nebulous definition of what “professionalism” even is, the lectures at least serve to explain the pharmacy-specific-definition of the word.

In addition, one of the more subtle issues with the concept of professionalism is the rather dangerous implication it makes. It implies, by the word itself, that non-professionals don’t have to hold themselves to higher standards of moral or ethical behavior. This implication serves to launch yet another attack upon the term; that holding oneself to higher behavioral and competence standards should not be discerned by what you do but by who you are. Should a taxi cab driver, a barber, a short order cook, or any other occupation not generally considered a professional hold themselves to any lower standards of behavior? Does wearing an apron to work instead of a white coat allow someone to be any less punctual, personable, honest, kind or moral? One could certainly argue that the consequences of unprofessional behavior from our medical or legal professionals are potentially severe. But so are the consequences of “unprofessional” behavior from our investment bankers, our airline pilots, our preschool teachers and our police officers. Would it be unreasonable to propose that professionalism be renamed to “Humanism”; the characteristics demonstrated by good humans? One would hope, although it would be naïve to honestly believe, that every person, everywhere, would try to hold themselves to the highest standards of behavior. Not just our pharmacists, our physicians our lawyers or our priests. Not just those occupations that possess tremendous consequences for poor or immoral performance. And although it will doubtlessly be controversial, I contend that these values are not something that can be taught in a 25 slide PowerPoint at the beginning of a pharmacy skills lecture. These attributes are learned and acquired through a positive upbringing, supportive experiences and an intrinsic desire to be a better person.

To respond, finally, to the prompt; I would say my current level of “professionalism” is moderately high. But I do not believe this has much, if anything, to do with my profession or education. There is a comment box below if anyone strongly agrees or disagrees with my thoughts. An open discourse on this topic could prove valuable to future students.